A novel technique for middle meningeal artery embolization with proximal coiling for subdural hematoma…

Cohort studyJournal of cerebrovascular and endovascular neurosurgery· Aug 2026

A novel technique for middle meningeal artery embolization with proximal coiling for subdural hematoma: Institutional predictors of surgical requirement and longitudinal outcomes.

Jeffrey Miller, Frantz Flambert, Marc Babi, Bernard R Bendok

NeuroendovascularCohort studyQ3IF 0.9

Higher BMI independently predicted need for surgical drainage after middle meningeal artery embolization

A novel technique for middle meningeal artery embolization with proximal coiling for subdural hematoma: Institutional predictors of surgical requirement and longitudinal outcomes.

Jeffrey Miller … Bernard R Bendok

Journal of cerebrovascular and endovascular neurosurgery · Aug 2026 · Q3 in Surgery

Purpose

To evaluate single-operator outcomes of a standardized proximal Middle Meningeal Artery Embolization (Middle Meningeal Artery Embolization) technique using platinum microcoils across the subdural hematoma (subdural hematoma) acuity spectrum, and to identify clinical and anatomical predictors associated with adjunct surgical drainage.

Methods

We retrospectively reviewed 100 consecutive adult patients (standalone Middle Meningeal Artery Embolization: n=53; Middle Meningeal Artery Embolization with surgical drainage: n=47).

n = 53

Results

each 1-point higher BMI slightly raised the odds of needing surgical drainage

AOR by subgroup · 95% CI

More results

Continuous variables exhibited non-normal distributions (p≤0.010); median cohort body mass index (BMI) was 26.6 kg/m² (IQR 22.5-29.8).

Technical success was 100%, with zero periprocedural complications and zero surgical re-evacuations at 6 months (0%).

More results

Fluoroscopy time (p=0.969) and coil count (p=0.393) were uniform across acuity cohorts.

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Conclusion · 1 of 2

Proximal Middle Meningeal Artery Embolization with microcoils is safe, highly feasible, and technically consistent across all subdural hematoma acuity phases.

Conclusion · 2 of 2

Although hematoma thickness traditionally guides surgical intervention, elevated BMI, headache presentation, and hemispheric laterality serve as vital independent clinical predictors for adjunct surgical drainage.

A novel technique for middle meningeal artery embolization with proximal coiling for subdural hematoma: Institutional predictors of surgical requirement and longitudinal outcomes.

A novel technique for middle meningeal artery embolization with proximal coiling for subdural hematoma: Institutional predictors of surgical requirement and longitudinal outcomes.

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